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  #1   ^
Old Fri, Jan-11-19, 10:13
teaser's Avatar
teaser teaser is offline
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Plan: mostly milkfat
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Default Whole grains reduce risk

https://www.sciencedaily.com/releas...90110184737.htm

Quote:
High intake of dietary fiber and whole grains associated with reduced risk of non-communicable diseases

The results suggest a 15-30% decrease in all-cause and cardiovascular related mortality when comparing people who eat the highest amount of fibre to those who eat the least. Eating fibre-rich foods also reduced incidence of coronary heart disease, stroke, type 2 diabetes and colorectal cancer by 16-24%. Per 1,000 participants, the impact translates into 13 fewer deaths and six fewer cases of coronary heart disease.

In addition, a meta-analysis of clinical trials suggested that increasing fibre intakes was associated with lower bodyweight and cholesterol, compared with lower intakes.

The study was commissioned by the World Health Organization to inform the development of new recommendations for optimal daily fibre intake and to determine which types of carbohydrate provide the best protection against non-communicable diseases (NCDs) and weight gain.

Most people worldwide consume less than 20 g of dietary fibre per day. In 2015, the UK Scientific Advisory Committee on Nutrition recommended an increase in dietary fibre intake to 30 g per day, but only 9% of UK adults manage to reach this target. In the US, fibre intake among adults averages 15 g a day. Rich sources of dietary fibre include whole grains, pulses, vegetables and fruit.

"Previous reviews and meta-analyses have usually examined a single indicator of carbohydrate quality and a limited number of diseases so it has not been possible to establish which foods to recommend for protecting against a range of conditions," says corresponding author Professor Jim Mann, the University of Otago, New Zealand.

"Our findings provide convincing evidence for nutrition guidelines to focus on increasing dietary fibre and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases."

The researchers included 185 observational studies containing data that relate to 135 million person years and 58 clinical trials involving 4,635 adult participants. They focused on premature deaths from and incidence of coronary heart disease, cardiovascular disease and stroke, as well as incidence of type 2 diabetes, colorectal cancer and cancers associated with obesity: breast, endometrial, esophageal and prostate cancer. The authors only included studies with healthy participants, so the findings cannot be applied to people with existing chronic diseases.

For every 8g increase of dietary fibre eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 5-27%. Protection against stroke, and breast cancer also increased. Consuming 25g to 29g each day was adequate but the data suggest that higher intakes of dietary fibre could provide even greater protection.

For every 15g increase of whole grains eaten per day, total deaths and incidence of coronary heart disease, type 2 diabetes and colorectal cancer decreased by 2-19%. Higher intakes of whole grains were associated with a 13-33% reduction in NCD risk -- translating into 26 fewer deaths per 1,000 people from all-cause mortality and seven fewer cases of coronary heart disease per 1,000 people. The meta-analysis of clinical trials involving whole grains showed a reduction in bodyweight. Whole grains are high in dietary fibre, which could explain their beneficial effects.

The study also found that diets with a low glycaemic index and low glycaemic load provided limited support for protection against type 2 diabetes and stroke only. Foods with a low glycaemic index or low glycaemic load may also contain added sugars, saturated fats, and sodium. This may account for the links to health being less clear.

"The health benefits of fibre are supported by over 100 years of research into its chemistry, physical properties, physiology and effects on metabolism. Fibre-rich whole foods that require chewing and retain much of their structure in the gut increase satiety and help weight control and can favourably influence lipid and glucose levels. The breakdown of fibre in the large bowel by the resident bacteria has additional wide-ranging effects including protection from colorectal cancer." says Professor Jim Mann.

While their study did not show any risks associated with dietary fibre, the authors note that high intakes might have ill-effects for people with low iron or mineral levels, for whom high levels of whole grains can further reduce iron levels. They also note that the study mainly relates to naturally-occurring fibre rich foods rather than synthetic and extracted fibre, such as powders, that can be added to foods.

Commenting on the implications and limitations of the study, Professor Gary Frost, Imperial College London, UK, says, "[The authors] report findings from both prospective cohort studies and randomised controlled trials in tandem. This method enables us to understand how altering the quality of carbohydrate intake in randomised controlled trials affects non-communicable disease risk factors and how these changes in diet quality align with disease incidence in prospective cohort studies. This alignment is seen beautifully for dietary fibre intake, in which observational studies reveal a reduction in all-cause and cardiovascular mortality, which is associated with a reduction in bodyweight, total cholesterol, LDL cholesterol, and systolic blood pressure reported in randomised controlled trials... There are some important considerations that arise from this Article. First, total carbohydrate intake was not considered in the systematic review and meta-analysis... Second, although the absence of association between glycaemic index and load with non-communicable disease and risk factors is consistent with another recent systematic review, caution is needed when interpreting these data, as the number of studies is small and findings are heterogeneous. Third, the absence of quantifiable and objective biomarkers for assessing carbohydrate intake means dietary research relies on self-reported intake, which is prone to error and misreporting. Improving the accuracy of dietary assessment is a priority area for nutrition research. The analyses presented by Reynolds and colleagues provides compelling evidence that dietary fibre and whole grain are major determinants of numerous health outcomes and should form part of public health policy."



Suppose I told you about a meta study of 185 observational studies that showed better outcomes in type I diabetics who used insulin to control their blood sugars. First question--why 185 studies? You don't prove something with 185 studies, you prove it with one, or at least a small series, of well-designed studies. This horse is dead, we know that the people eating higher whole grain seem to do better, the question of whether it's due to the whole grain--or to the fact that while pop tarts are now whole grain, most whole grain foods thankfully are not pop tarts, or to the general pattern of diet and lifestyle that includes whole grain can't be answered by doing the same silly study another 185 times (but they'll do it anyways).

Another interesting thing from this sort of article is the mention of gut bacteria. Often claims of healthfulness of whole grains, which most in our culture will read as "wheat" will appeal to gut bacteria fermenting the fiber to our benefit, meanwhile most of the fiber we're being encouraged to eat here is the non-soluble, mostly non-fermentable, at least in the human gut, sort.
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  #2   ^
Old Fri, Jan-11-19, 12:30
Meme#1's Avatar
Meme#1 Meme#1 is offline
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I had a Gastrointestinal doctor ask me, Did you get sick after starting Low-carb? My answer was, No I started Low-carb after I got sick!
Another Gastro. doctor told me to eat oatmeal. He said a good way to get it it is in Oatmeal cookies...that's what he does!
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  #3   ^
Old Fri, Jan-11-19, 12:30
CityGirl8 CityGirl8 is offline
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Plan: Protein Power, IF
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Default

These kinds of studies always irritate me. They are making assumptions not in evidence. Correlation does not equal causation.

People whose diets tend to include more whole grains also tend to include less sugar, etc. and with the increase in fiber, tend to have a lower net carb intake overall. If they didn't control for those factors in their review of the studies, then they probably don't have any meaningful results.

At the same time, some people eat more whole grains tend to eat less protein (vegetarians, semi-veg, etc.). They probably didn't control for that either.

Trying to extract one factor without understanding or considering how the others affect it is useless.
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  #4   ^
Old Fri, Jan-25-19, 15:26
Grav Grav is offline
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Default

Notice how they make multiple references to nutrition guidelines and policy. Prof Mann has served on guideline advisory committees here in New Zealand for years; his political influence in this area is hard to understate.

The same attitudes were very much prevalent at the public presentation on this findings of this study, which I attended last year. They framed it as a study on the quality of carbohydrate intake, while at the same time refusing to take any questions on the quantity of carbohydrate intake.

Just another example of a study concocted to reinforce the preconceived beliefs of the authors and the position of influence that they currently enjoy.
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  #5   ^
Old Fri, Jan-25-19, 21:19
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GRB5111 GRB5111 is offline
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Sometimes I get the impression that the blizzard of words in these types of studies serves to camouflage of the real issues. Nothing more needs to be said.
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